MEDICARE: BRENDA STRONG SHARPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1003667106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA STRONG SHARPE

Provider Business Mailing Address
First Line	:	12122 KILBOURNE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48213-1376
Country	:	US
Telephone Number	:	313-575-2998
Fax Number	:

Provider Business Practice Location Address
First Line	:	12122 KILBOURNE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48213-1376
Country	:	US
Telephone Number	:	313-575-2998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	03/28/2024

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Directions to “ BRENDA STRONG SHARPE ” Practice Location

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